At some point, you and your family members will need to visit a doctor and you may even need to go to the hospital. Knowing your benefits and how your medical plan works, can help alleviate some of the stress and allow you to focus on the medical needs you and your family may be facing. This brochure will help you understand how to use your health insurance wisely, as well as offer suggestions on how to improve your health and keep your health care costs to a minimum.

THINGS TO CONSIDER

• Talk to your physician about your treatment. Take a list of questions to ask your doctor during your visit. A recommended list can be found in the ConsumerWISE area of our Web site. Make sure you understand the costs that will be involved. Be a wise consumer.

• Use medications on your health plan’s prescription drug formulary. If your physician prescribes a new drug, ask for a free sample—make sure it works before you purchase a 30- or 90-day supply. And using generic drugs instead of brand-name medications will save you money.

Checklist

Make sure you receive medical care from contracted providers, if possible

Call us before receiving care regarding treatment that should be preauthorized

Coordinate treatment with your primary care physician, if required

Follow your doctor’s orders (for example, don’t stop taking medications just because the symptoms disappear, etc.)

Make sure all of your claims are submitted within 15 months of treatment

• Use the Healthwise Handbook to evaluate the illness or injury and to help you decide whether to try and treat it at home or go to the doctor. There’s also some helpful information on prevention. You can get a Healthwise Handbook free by attending one of our Healthwise seminars.

• Participate in a Lifestyle Screening. This screening involves an interview and examination that evaluates your health and recommends specific things you can do to improve your physical well-being. Some medical plans may even pay for a lifestyle screening.

• If you have a chronic illness, you should seriously consider enrolling in the Flexible Spending Account (FSA) program. This program allows you to pay your out-of-pocket share of medical and dental expenses with tax-free money.

• Look into the long-term care options available from MetLife and decide if one of them fits your needs.

FREQUENTLY ASKED QUESTIONS

A. Review your Benefits Handbook to find out what medical services should be preauthorized. Call us to preauthorize medical care that needs to be preauthorized.

A. You can find a list of contracted providers or contact your HMO. And remember, when someone at a doctor’s office says they accept your insurance, it simply means they are willing to bill your insurance—it does not necessarily mean they’re a contracted provider.

A. If your medical or dental providers are contracted, they’ll submit the claim for you. If not, send us (or your HMO) a copy of your itemized bill. Make sure the health provider’s name is on the bill along with their address, the date of service, and a description of what treatment was provided (diagnostic and procedure codes, etc.) And make sure your member ID number is on the claim!

A. Call us about how to file claims for work related injuries, injuries sustained as part of a church activity, or injuries caused by auto accidents or other accidents where a third party may be responsible to pay.

A. Long-term care insurance provides for you and your family when you cannot provide for yourself. The insurance provides a daily benefit that you can apply toward the costs for nursing homes, hospice care, assisted living services, etc. For more information, contact MetLife at 1-800-438-6388.

A. We offer some tools that can help you find out. First, complete the FSA Estimation Worksheet. This will help you estimate your annual out-of-pocket expenses. Then, use the Paycheck Calculator in the Savings area of our Web site. This tool will show you what your projected tax savings will be by participating in the FSA program.

This information is provided as a service to help you make informed decisions. Nothing in this information should be considered legal, financial, investment, or medical advise. For a complete description of the plans. please refer to your Benefits Handbook. As with any major life event, you should consult with qualified prefessionals of your choice who can provide you with appropriate counsel and advise.

ILLNESS AND INJURY

THINGS TO CONSIDER

Checklist

FREQUENTLY ASKED QUESTIONS